A look inside the lab

A look inside the lab

Transcript

The Caris Lab

Caris has one of the most unique and comprehensive labs in this country.

We are a company that believes in moving with the cutting edge of technology, but also being responsible with it.

We’re an information powerhouse. We have one of the most sophisticated computational systems that can be made. We’ve partnered with IBM to create a massive parallel computing system. And we have molecular grade science applied to traditional pathology work flows.

Our certifications

We’re CLIA certified and CAP accredited and we’re also ISO accredited, which is one of the highest accreditations that a lab can achieve worldwide.

We achieve these certifications by putting quality first. It’s important for the patient to get the best result. It’s not just enough to get a result, you want a result you can rely on.

What happens to your tissue sample in the lab

So everything starts in accessioning, where we open up the package with a video recording and making sure the specimen is complete. We then move into the lab and go to the cutting stations, where the block is turned into slides.

Those slides are the stained H&E, in the beginning the middle and the end and sent for pathological review.

Once a sample has been reviewed by our pathologist, it moves into the lab for IHC staining. In order to evaluate the quality of our staining and to normalise the results we use a tissue micro-array, that’s put on every slide.

What is unique about Caris Molecular Intelligence?

We do more cancer specific treatment geared IHC work than any other laboratory and it’s only at that volume that you can see the broad heterogeneity between different cancer cases and know what’s important in terms of interpreting those results and helping the oncologist inform their treatment decisions.

Cancer is not a solid piece of tissue. It’s intermixed with normal cells and when you’re doing any molecular test you want to enrich for the cancer tumour nuclei as much as possible. So we perform microdissection on 100% of our cases and that’s critically important, because if you have a low density tumour, you’re going to miss alterations that could potentially impact the treatment decisions made by the oncologist.

Quality controls

We take those tumour nuclei and then we extract the DNA from the cancer cells for downstream analysis. From there, we have a pre-amp room which is our cleanest space; there’s positive air pressure, there are locking interchangeable doors, we do that to keep that range in the room and clean as possible.

In order to prevent contamination we do all of our PCR setup in dead air boxes, behind an airlock. Once the samples have been assembled, we move into our post-amplification room where the samples are actually processed.

Tests which generate information about the tumour

We do next generation sequencing, we do methylation, we do pyro-sequencing, we do fragment analysis. All of those technologies are housed in the post-amp room, and we do a very comprehensive suite of testing on all of the DNA and RNA that is extracted from these samples.

Once all of the data has been retrieved from the instruments and verified for quality, all the data still goes through a molecular geneticist. It’s important that a molecular geneticist review the data and put that information in the appropriate context that can be understood by the ordering physician.

It’s then transferred over to the molecular pathologist and integrated with all of the data generated in the IFC laboratory. If any discrepancies are identified, we meet as a group, pathologists and geneticists to determine what the best course of action is, on a one by one patient basis. We then produce that final comprehensive molecular profiling report.

A rigorous, personalised approach

It’s these types of steps that really separate out the Caris laboratory from any other molecular profiling laboratories. It’s something that we take great pride in because we put a lot of effort into it.

We understand that every sample that comes through this door is a real live patient, it’s a mother, it’s a father, who needs therapy, who needs answers. We also understand the responsibility that comes with that. We need to be able to provide high quality results for every patient to make sure they’re getting the right therapy at the right time.

A unique laboratory

Caris is an incredible place to work. It is one of the most unique laboratories in the world. We have every available technology at our finger tips to ensure that we’re enabling oncologists to do the best by their patient that they possibly can.

It’s this comprehensive suite of offering that allows Caris to be the number one molecular profiling service company in the world today.